Effect Of Neutrophil-lymphocyte Ratio Research Articles

The effect of neutrophil lymphocyte ratio and other biochemical parameters on mortality in cancer patients admitted to the emergency department

Aims: To investigate the effectiveness of the neutrophil/lymphocyte ratio and other biochemical parameters in predicting mortality in oncology patients with cancer admitted to the emergency department. Methods: This was a retrospective, observational, single-center study. The study period included a two-year period from January 2014 to December 2015. Demographic data, cancer history and blood tests, emergency department diagnoses, blood parameters evaluated in the emergency department, discharge, and mortality status of the patients were recorded in the data form. The APACHE 2 and SOFA scores of all patients were also calculated. Patients whose data could not be reached were excluded from the study. p<0.05 was considered statistically significant. Results: A total of 180 patients were included in the study. The mean age of the survivor group was 66.4±10.752 years, while the mean age of the non-survivor group was 65.18±13 years. The mean neutrophil/lymphocyte (NLR) ratio of the non-survivor group was 1.0288±11.3, while the NLR of the survivor group was 4.400±3.563. (p<0.05) The mean lactate ratio of the non-survivor group was 2.60±3.384, while the mean lactate ratio of the survivor group was 1.36±1. 090. (p<0.05) When survivor and non-survivor patient groups were compared, a statistically significant difference was observed in mean white blood cell count, neutrophil count, hemoglobin, hematocrit, and blood urea nitrogen (BUN) values. (p<0.05) Conclusion: According to the results of this study, NLR, elevated white blood cell and neutrophil values, decreased hemoglobin and hematocrit, and elevated BUN and lactate levels seem to be predictors of mortality during emergency admissions in cancer patients.

T-cells infiltration mediates the association between neutrophil/lymphocyte ratio and survival in gastric cancer.

Neutrophil/lymphocyte ratio (NLR) is a vital index for systemic inflammation and a prognostic indicator for gastric cancer (GC). Despite the abundant literature on NLR's prognostic value for GC, the underlying factors mediating its impact on survival remain unclear. The objective of this study was to analyze the role of NLR in different prognostic models and subgroups, and investigate the mediating effects of immune infiltrates between NLR and survival. A total of 924 patients who underwent D2 lymph node resection were enrolled in this study. According to the level of NLR, patients were divided into two groups, the high and low NLR groups. Clinical parameters, indexes related to immune infiltrates, and survival were compared between the two groups. Prognostic models, interaction analysis, and mediating effects analysis were performed to investigate the clinical association of NLR, immune infiltrates, and survival. The infiltration of CD3+ and CD8+ T cells was significantly different in the two NLR groups. The level of NLR was an independent prognostic predictor of GC. In addition, an interaction effect exists between NLR and MMR status on the prognosis of GC (p-interaction <0.01). Lastly, the mediating effect analysis revealed that the infiltration level of CD3+ T cells was the mediating factor between NLR and survival (p < 0.001). The level of NLR is an independent prognostic predictor of GC. The effect of NLR on prognosis is partly mediated by CD3+ T-cell infiltration.

The effect of neutrophil-lymphocyte ratio on neck nodule size in nasopharyngeal carcinoma chemotherapy

ABSTRACTBackground: Nasopharyngeal carcinoma (NPC) is a cancer of the head and neck, that ranks as the 4th most malignant cancer in Indonesia. The prognosis of NPC patients is determined from the clinical stage based on the Tumor, Nodule, Metastatic (TNM) classification system. These prognosis factors are not entirely reliable for predicting treatment outcomes. The Neutrophil Lymphocyte Ratio (NLR) represents an index of pro-tumor and anti-tumor activity, that can be used to predict the outcome of neoadjuvant chemotherapy and the patient’s well-being as assessed by Karnofsky status, Body Mass Index (BMI), and neck nodule size (NNS). Purpose: To study the effect of NLR on Karnofsky status, BMI, and NNS in WHO type III NPC patients who underwent 3 cycles of neoadjuvant chemotherapy. Method: Analytical observational research with a cohort-retrospective approach on WHO type III NPC subjects who underwent platinum-based regimen neoadjuvant chemotherapy. NLR pre-chemotherapy was analyzed for its effect on Karnofsky status, BMI, and NNS. Result: NLR had no significant effect on Karnofsky status pre- and post-chemotherapy, BMI pre- and post-chemotherapy, NNS pre-chemotherapy, changes in Karnofsky status and BMI pre-and post-chemotherapy, but had significant effect on the size of neck nodules post-chemotherapy, and changes in the size of neck nodules. Conclusion: NLR has no significant effect on Karnofsky status, on BMI pre- and post-chemotherapy, and neck nodule size pre-chemotherapy. However, NLR had a significant effect on neck nodule size post-chemotherapy and neck nodule size changes. ABSTRAKLatar belakang: Karsinoma Nasofaring (KNF) merupakan keganasan dalam bidang THT yang menempati urutan ke-4 keganasan di Indonesia. Prognosis pasien KNF terutama ditentukan dari stadium klinis berdasarkan sistem klasifikasi Tumor, Nodul, Metastasis (TNM) yang tidak sepenuhnya dapat diandalkan untuk memprediksi hasil pengobatan. Sedangkan Ratio Netrofil-Limfosit (RNL) mempresentasikan indeks aktivitas protumor dan antitumor sehingga dapat digunakan sebagai pelengkap stadium klinis untuk memprediksi hasil kemoterapi neoadjuvan dan kesejahteraan subjek melalui status Karnofsky, Index Massa Tubuh (IMT) dan ukuran nodul leher. Tujuan: Mempelajari efek Rasio Netrofil-Limfosit (RNL), Index Massa Tubuh (IMT), dan ukuran nodul leher pada subjek dengan KNF WHO tipe III yang telah menjalani 3 siklus kemoterapi neoadjuvan. Metode: Penelitian observasional analitik dengan pendekatan kohort-retrospektif menggunakan data rekam medis penderita KNF tipe III WHO yang menjalani kemoterapi neoadjuvan menggunakan regimen berbasis platinum. RNL sebelum kemoterapi dianalisis pengaruhnya terhadap status Karnofsky, IMT dan ukuran nodul leher. Hasil: RNL berpengaruh tidak signifikan terhadap status Karnofsky sebelum dan sesudah kemoterapi, IMT sebelum dan sesudah kemoterapi, ukuran nodul leher sebelum kemoterapi, perubahan status Karnofsky, perubahan IMT, namun berpengaruh signifikan terhadap ukuran nodul leher sesudah kemoterapi dan perubahan ukuran nodul leher. Kesimpulan: RNL berpengaruh tidak signifikan terhadap status Karnofsky, IMT sebelum dan sesudah kemoterapi, ukuran nodul leher sebelum kemoterapi, namun berpengaruh signifikan terhadap ukuran nodul leher sesudah kemoterapi dan perubahan ukuran nodul leher sebelum kemoterapi, namun berpengaruh signifikan terhadap ukuran nodul leher sesudah kemoterapi dan perubahan ukuran nodul leher.

The Role of Pre-treatment Inflammatory Biomarkers in the Prediction of an Early Response to Panitumumab in Metastatic Colorectal Cancer.

BackgroundSystemic inflammation is a critical component of the development and progression of several types of cancer. Neutrophil-lymphocyte ratio (NLR) and lymphocyte-monocyte ratio (LMR) are simple, inexpensive, and reliable predictors of the systemic inflammatory response to the therapy in different malignant tumors, including colorectal cancer.MethodsMetastatic colorectal cancer (mCRC) patients treated with panitumumab plus chemotherapy at first-line at the medical oncology unit of Fondazione Institute for Research, Hospitalization and Health Care (IRCCS) Policlinico San Matteo di Pavia between January 1st 2016 and February 1st 2021 were retrospectively analyzed. NLR and LMR were divided into two groups (high and low) based on the cut-off points, with the estimation of the prognostic accuracy of NLR for the early treatment response as the primary end-point of this study.ResultsThe receiver operating characteristic (ROC) analysis showed a fair prognostic accuracy of NLR for early treatment response (area under the curve (AUC)=0.76, 95% CI: 0.62-0.89). A slightly lower prognostic accuracy was found for LMR (AUC=0.71, 95% CI: 0.57-0.85). In the univariable proportional hazard Cox model, no effect of NLR on PFS was found (NLRHigh vs. NLRLow HR=1.3; 95% CI: 0.7-2.4, p=0.414). Patients with higher levels of LMR showed a trend towards higher PFS (LMRHigh vs. LMRLow HR=0.4; 95% CI: 0.2-1.1, p=0.066). No association was found between NLR (or LMR) and skin toxicity.ConclusionsNLR and LMR may be used as biomarkers of prognostic accuracy for the early treatment response in mCRC patients treated with panitumumab.

The effect of neutrophil lymphocyte ratio on mortality in patients followed in the intensive care unit with the diagnosis of ischemic stroke from the emergency department

The goal of this study was to determine if the neutrophil-lymphocyte ratio (NLR) predicts mortality in patients hospitalized in the intensive care unit (ICU) with an ischemic stroke. Between January 1 and December 31, 2021, 116 patients admitted to our emergency department with the diagnosis of ischemic stroke and hospitalized in the 3rd level ICU unit were included in the study and divided into two groups: patients who died (Group 1: n=62) and patients who survived (Group 2: n=54). Patients’ age, gender, presence of chronic diseases, Acute Physiology and Chronic Health Evaluation (APACHE) II score, and neutrophil count, lymphocyte count, and NLR were obtained by dividing these two numbers in the first complete blood count taken at the time of admission to the emergency department were collected and analyzed. While 54 (46.5%) patients were discharged from the ICU, 62 (53.4%) patients died. 60 (51.7%) of the patients were female. The average age of patients was 76.85±10.70. APACHE II score was found to be correlated with mortality (AUC 0.70, 95% CI (0.616-0.802) (p=0.01). When the APACHE II cut-off value was more than 13.5, it predicted mortality with 95% sensitivity and 85% specificity. The median NLR ratio of the patients was found to be 5.08 (0.38-35.16) in the survivors and 11.68 (1.38-113.00) in patients that died. NLR was lower in survivors (p=0.002). NLR may be a valuable marker in predicting mortality in stroke patients admitted to the ICU.

The effect of neutrophil-lymphocyte ratio on admission to postoperative intensive care and mortality in elderly patients undergoing hip fracture surgery with spinal anesthesia

Objectives: Hip Fractures (HF) affect the elderly in particular, and are associated with high mortality rates. Most geriatric patients are admitted to Intensive Care Unit (ICU) after HF surgery. In this study, the purpose was to investigate the prognostic value of preoperative NLR (Neutrophil-to-Lymphocyte Ratio) on postoperative ICU admission and mortality in elderly patients with HF. Methods: In the present study, the data of 188 geriatric patients who underwent surgery because of isolated HF (i.e. femur neck and intertrochanteric fracture) were examined retrospectively. The patients over 65 years of age, ASA score 3/4, whose preoperative duration was less than 72 hours, and who underwent spinal anesthesia were included in the study. The patients were divided into two groups as ICU admission (ICU, n = 58), and Non-ICU (Non-ICU, n = 130). The patients were also grouped as Survival (n = 168) and Non-survival (n = 20) according to postoperative mortality rates. NLR values were statistically compared between the groups. Results: The preoperative NLR values of the patients in the ICU Group were significantly higher than those in the Non-ICU Group (p &amp;lt; 0.001). The cut-off value of NLR for ICU admission was found to be 9.65 with 89% sensitivity and 67% specificity in the ROC analysis. The median NLR value was 6.42 (3.55-9.44) in the Survivor Group, and 9.5 (7.23-11.02) in the Non-Survivor Groups (p = 0.015). Conclusions: It was shown in the study that high NLR values in elderly patients may be a risk factor for ICU admission, and for postoperative mortality after HF.

Prospective Evaluation of the Effects of Neutrophil-lymphocyte Ratio on Mortality after Elective Vascular Surgical Procedures

Prospective Evaluation of the Effects of Neutrophil-lymphocyte Ratio on Mortality after Elective Vascular Surgical Procedures

The Effect of Neutrophil-lymphocyte Ratio on 10-year Survival Outcomes Following Elective Open and EVAR Procedures

The neutrophil-lymphocyte ratio (NLR) is a useful and inexpensive inflammatory marker associated with surgical outcomes. This study evaluates the effects of NLR on survival after elective endovascular (EVAR) and open aortic repair (OAR) of abdominal aortic aneurysm.

Lymphocyte-to-Monocyte Ratio is Associated with the Poor Prognosis of Breast Cancer Patients Receiving Neoadjuvant Chemotherapy.

PurposeSystemic inflammatory cell ratio, neutrophil–lymphocyte ratio (NLR), platelet–lymphocyte ratio (PLR), and lymphocyte–monocyte ratio (LMR) are used as prognostic indicators for several types of tumors. The purpose of this study was to evaluate the predictive value of inflammatory markers for pathological response and prognosis in breast cancer patients receiving neoadjuvant chemotherapy (NAC).MethodsIn this study, we collected data of 203 breast cancer patients who underwent surgery after receiving standard neoadjuvant therapy. The effects of NLR, PLR, and LMR on the disease-free survival (DFS) of patients with breast cancer were analyzed by χ2 test and Cox regression analyses.ResultsWe found that 27 of the 203 patients (13.3%) had local or distant metastases. The peripheral blood NLR, PLR, and LMR areas under the curve (AUC) were 0.674 (0.555–0.793), 0.630 (0.508–0.753), and 0.773 (0.673–0.874), respectively. The optimal cutoff values were 3.0, 135, and 6.2, respectively. Univariate and multivariate analyses revealed that LMR was related to the pathological complete response (pCR) rates and breast cancer DFS (P < 0.05). Among all patients, those with low LMR, HER-2 positive, and lymph node status (N2–3) demonstrated poor DFS.ConclusionOur study thus demonstrated that LMR can act as a potential marker for predicting the efficacy and prognosis of patients with breast cancer.

Can Preoperative Neutrophil-Lymphocyte Ratio and Platelet-Lymphocyte Ratio Predict Systemic Inflammatory Response Syndrome That Develops After Percutaneous Nephrolithotomy?

Objective: First objective of this study was to find out factors influencing development of postoperative systemic inflammatory response syndrome (SIRS) after percutaneous nephrolithotomy (PNL). Secondary objective was to point out the role of preoperative neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) in SIRS estimation. Method: The data of 756 patients that underwent PNL for kidney stones between 2012 and 2019 were evaluated retrospectively. Patients were divided into 2 groups as non-SIRS and SIRS group. The effects of NLR, PLR and other operative and demographic variables on development of SIRS were investigated. Multivariate logistic regression analysis that was performed on variables that were significant in the univariate analyses was used to establish independent risk factor for post-PNL SIRS. Results: Univariate analysis revealed a significant association between presence of SIRS and preoperative PLR (p&lt;0.001), preoperative NLR (p&lt;0.001), blood transfusion (p&lt;0.001), stone volume (p=0.03), staghorn stone (p&lt;0.001), and preoperative creatinine levels (&lt;0.001). Multivariate logistic regression analyses of these risk factors showed that NLR (p&lt;0.001), PLR (p&lt;0.001), and blood transfusions (p&lt;0.001) were independently associated with SIRS. When the cut-off value of PLR was 120.5, the development of SIRS was predicted with 80.1% specificity and 81% sensitivity. When the cut-off value of NLR was 2.75, the development of SIRS was predicted with 64% specificity and 63.7% sensitivity. Conclusion: Preoperative PLR and NLR are effective and inexpensive biomarkers that can be used to predict SIRS and sepsis after PNL. We recommend that patients with PLR &gt;120.5, NLR &gt;2.75, and blood transfusions should be monitored closely due to the possible development of serious complications.

The effect of neutrophil-lymphocyte ratio in patients with COPD in Sohag University Hospital

NLR has also been evaluated as diagnostic and prognostic marker in COPD. Chronic inflammation in COPD resulting in the recruitment of the lymphocytes and neutrophils. Which, once activated, release neutrophil elastase, cathepsin G, proteinase-3, matrix metalloproteinase (MMP)-8 and MMP-9, and myeloperoxidase (MPO), which contribute in the pathophysiological mechanisms of emphysema and COPD.Aim of study Evaluate the NLR as a biomarker that can detect the severity and duration of COPD in patients with acute exacerbation and frequency of future exacerbation; we thus monitored NLR in COPD to evaluate it as a biomarker in patients and investigated its association with a variety of clinical aspects of COPD.Methodology It was a prospective observational study that was carried out among COPD patients with acute exacerbation and asymptomatic persons (controls). The study included 67 participants, 38 cases were COPD patients while 39 cases were healthy controls who were older than 40 years. The study was conducted among patients who admitted to chest department of Sohag University Hospital during period between February 2019 to January 2020, after the approval of the ethical committee and written consents where taken from the participants. Patients were diagnosed to have COPD according to the GOLD. The following laboratory investigations were done: complete blood count (CBC) inflammatory markers as neutrophil-lymphocyte ratio (NLR), were evaluated.Results The mean age of the studied COPD cases was 63.5(7.8) years and the mean age of the controls was 60(6.5) years. All the studied COPD cases and the matched controls were males. Compared to controls the levels of neutrophil, lymphocyte, basophil, eosinophil, NRL and platelet were significantly higher among the studied COPD cases. There was significant positive correlation between levels of leucocytes, neutrophils and NLR and duration of exacerbation. While, lymphocytes level was inversely associated with duration of exacerbation.Conclusions The present study demonstrates that NLR is associated with mortality and duration exacerbations, in COPD patients. For predicting exacerbations, we estimated the threshold of NLR to be 1.3 at baseline.

Correlation of neutrophil-lymphocyte ratio and the clinical progression of benign prostatic hyperplasia

Objective To evaluate the relationship between neutrophil-lymphocyte ratio(NLR) and benign prostatic hyperplasia(BPH), and to explore the effect of NLR on clinical progression in patients with BPH. Methods A retrospective analysis of clinical data of 274 patients with BPH who admitted to the department of urology, the first affiliated hospital of Xiamen university from January 1, 2015 to December 31, 2017 was performed. Statistical methods were used to analyze the correlation between NLR and prostate volume(PV), international prostate symptom score(IPSS), maximum urinary flow rate(Qmax), and prostate-specific antigen(PSA). According to age, PV, IPSS, Qmax, PSA, the patients were divided into high-risk group and low-risk group, and NLR was compared between these groups. The receiver operating characteristic(ROC) curve was used to analyze the capability of NLR in identifying patients at a high-risk of progression. Then, according to whether the postoperative pathology contains inflammatory cell infiltration, it was divided into non-invasion group and infiltration group, and statistical analysis was performed between the infiltration group. Results NLR was positively correlated with PV and IPSS(r=0.126, P=0.038; r=0.139, P=0.021), and negatively correlated with Qmax(r=-0.169, P=0.005), but not correlated with PSA(P>0.05). When the patients were divided into group based on PV and Qmax, the high-risk group had a significantly higher NLR than the low-risk group(t=2.338, P=0.020; t=2.763, P=0.006). When the patients were divided into group based on age, IPSS and PSA, there was no significant difference in NLR between high-risk group and low-risk group(P>0.05). The ROC curve analysis showed that NLR had a cut-off value of 1.71, a sensitivity of 71.0%, and a specificity of 49.1% in predicting high-risk PV, while it had a cut-off value of 1.49, a sensitivity of 79.4%, and a specificity of 30.3% in predicting high-risk Qmax.The infiltration group had a significantly higher NLR than the non-invasion group(t=2.156, P=0.032), and the comparison between the infiltration group was also statistically significant(F=9.959, P<0.001). Conclusions NLR is positively correlated with the progression of BPH, and is one of the important factors in the clinical progress of BPH. It can provide serious information of patients and can be used as one of the indicators for follow.up. Key words: Prostatic Hyperplasia; neutrophil-lymphocyte ratio; Prostate-Specific Antigen

The effect of neutrophil-lymphocyte ratio and thrombocyte index on inflammation in patients with periodic fever, aphthous stomatitis, pharyngitis, and adenitis syndrome

Background: The periodic fever, aphthous stomatitis, pharyngitis, and adenitis (PFAPA) syndrome is the most common periodic fever syndrome in childhood. Its pathogenesis and etiology remain unknown. This study aimed to determine whether or not the neutrophil-to-absolute lymphocyte ratio (NLR) and thrombocyte indices could be used as subclinical inflammation markers in healthy control group children and children with PFAPA syndrome during the attacks and attack-free periods.Materials and Methods: Twenty-eight children with PFAPA syndrome that presented to our clinic were enrolled in this study. As a control group, healthy children that presented to the general pediatrics polyclinic with the exact same age and sex as the patient group were recruited. The medical records of all participants were evaluated retrospectively.Results: The leukocyte and neutrophil counts, NLRs, platelet count-to-absolute lymphocyte ratios (PLRs), and C-reactive protein levels of the patients with PFAPA syndrome during the attack period were found to be significantly higher than during the attack-free period. Similarly, during the attack period, the leukocyte and neutrophil counts, NLRs, and PLRs were significantly higher compared to the healthy control group. Patients with PFAPA syndrome during the attack-free periods were compared with the control group, and their mean platelet volume (MPV) values were significantly lower than the control group.Conclusions: MPV in PFAPA syndrome patients was significantly lower during the inflammation. We observed a significant decrease in MPV values during the attack-free period compared to the control group, suggesting that subclinical inflammation continues in the attack-free period in PFAPA syndrome.

Mediation Effect of Neutrophil Lymphocyte Ratio on Cardiometabolic Risk Factors and Cardiovascular Events

Neutrophil to lymphocyte ratio (NLR), an inflammatory biomarker, is associated with cardiovascular events (CVEs), but its causal pathway is unknown. We aimed to explore the extent to which NLR is directly associated with CVEs or mediated through diabetes mellitus (DM), hypertension (HT) and creatinine (Cr). The study used data on 2,501 subjects from the Electricity Generating Authority of Thailand cohort 2002–2012. Two causal pathways A: NLR→(DM→Cr→HT)→CVEs and B: NLR→(DM → HT→Cr)→CVEs were constructed. A generalized structural equation model and 1,000-replication bootstrapping were applied. The incidence rate of CVE was 8.8/1000/year. Prevalence rates of HT, DM, and chronic kidney disease were 45.1%, 23.6%, and 16.5%, respectively. The total effect of NLR on CVEs was explained partly (44%) by a direct effect and partly (56%) by an indirect effect through DM, HT and Cr. For pathway A, the direct OR of NLR on CVE was 1.25 (95% CI: 1.13, 1.39); the ORs for the indirect effects of NLR on CVEs mediated through DM, Cr, and poor-controlled HT were 1.06 (95% CI: 1.01, 1.11), 1.01 (95% CI: 1.00, 1.02), and 1.07 (95% CI: 1.01, 1.14) respectively. Results were similar for pathway B. Our findings demonstrate that roughly half of the relationship between NLR and CVEs may be mediated through DM, HT and Cr.

The Effect of Neutrophil-Lymphocyte Ratio on Prognosis in Acute Hemorrhagic Stroke: A Retrospective Study

The Effect of Neutrophil-Lymphocyte Ratio on Prognosis in Acute Hemorrhagic Stroke: A Retrospective Study

Mean Platelet Volume as an Inflammation Marker, Possible Biomarker of Tumor Detection in Prostate Biopsy

Background: In the diagnosis of prostatic diseases, the need for markers other than prostate specific antigen (PSA) has been increasing in recent years. So, we aimed to determine the predictive value, the neutrophil lymphocyte ratio, platelet-to-lymphocyte ratio and mean platelet volume before prostate biopsy in predicting the results of pathology. Transrectal ultrasound-guided biopsy of the prostate was performed because of high PSA values and compared values of these parameters to predict of pathology results. Methods: 2715 patients who underwent 10 - 12 quadrant transrectal ultrasound-guided prostate biopsies between January 2008 and January 2018 have been evaluated retrospectively. Patients were divided into groups according to the biopsy pathology results by benign (group 1), atypical small acinar proliferation (ASAP) (group 2) and prostate cancer (group 3). A total of 204 patients who were benign prostate hyperplasia in 71 patients (34.8%), atypical small acinar proliferation in 80 (39.21%) and prostate adenocarcinoma (PCa) in 53 patients (25.98%) were included in the study by systematic sampling. Before the biopsy total PSA (tPSA), free PSA (fPSA), rate of percentage of free to total prostate specific antigen (f/tPSA) rate, PSA density (PSA-D), white blood cell (WBC) count, blood neutrophil count (NC), blood lymphocyte count (LC), neutrophil lymphocyte ratio (NLR), mean platelet volume (MPV), platelet count (PLT) and platelet-to-lymphocyte ratio (PLR) were measured and compared in all groups. Differences in continuous variables were assessed using the ANOVA. Logistic regression was used to analyze the linear relationship between predictive variables and pathology results. P Results: NLR and PLR values were lower in group 1 than group 2 and were found statistically significant between in group 1 and group 2 (p: 0.03 and p: 0.02, respectively). MPV value was found 1.7 times higher in patients who were diagnosed with ASAP pathology than those with benign pathologies. Although there was statistically significant increase in MPV values in logistic regression results, no statistically significant diagnostic value was found. In addition MPV value was found 0.5 times higher in patients who were diagnosed patients with ASAP than prostate cancer group. ROC analysis showed that the optimal threshold was 7.65 femtoliter (sensitivity: 51%; specificity: 30%) and was found to be a statistically significant diagnostic value to distinguish groups 2 and 3. The lowest value of MPV was found in group 3. Conclusions: In cases where the PSA value is insufficient in predicting the pathology result, the effect of NLR, PLR and MPV on differential diagnosis can be kept in mind. While NLR and PLR are more useful in the diagnosis of ASAP, MPV is more effective in the diagnosis of malignancy.

The effect of neutrophil-lymphocyte ratio on the postoperative course of coronary artery bypass graft surgery

Background/aim: Recovery after coronary artery bypass graft surgery (CABG) can be complicated, leading to postoperative morbidity. The roles of hematologic and surgery-related parameters are important. The main purpose of this study is to determine the role of preoperative and postcardiopulmonary bypass neutrophil/lymphocyte ratio (NLR) on postoperative recovery. Materials and methods: Sixty-two patients aged between 41 and 80 years, scheduled for elective CABG surgery with ASA I-II risk and without a history of preoperative blood transfusion, were included in the study. Three patients were excluded due to their need for additional surgical procedures other than CABG. The patients were divided into two groups that were formed depending on preoperative NLR cut-off values below (Group 1, n = 37) and above 4 (Group 2, n = 22). Postoperative data such as length of stay in the hospital and in the intensive care unit (ICU), chest tube drainage, and incidence of atrial fibrillation were recorded for all patients. Results: Preoperative NLR was significantly lower in Group 1 (P < 0.0001), and there was no significant difference between the groups in terms of postoperative NLR (P = 0.217) when the two groups were compared. The patients in Group 2 had a longer length of stay in the ICU (P = 0.035) and in the hospital (P = 0.034). There was a positive correlation between preoperative NLR and length of stay in the ICU (P = 0.017) and the hospital (P = 0.014). No statistically significant differences in postoperative drainage or incidence of postoperative atrial fibrillation were detected between the two groups. Conclusion: The results of our study demonstrate that the postoperative NLR may be useful to predict the length of hospital and ICU stays and help the management of follow-up and treatment processes in patients undergoing CABG surgery.

P4461Mediation effect of neutrophil lymphocyte ratio on cardiometabolic risk factors and cardiovascular events

P4461Mediation effect of neutrophil lymphocyte ratio on cardiometabolic risk factors and cardiovascular events

Evaluation of neutrophil–lymphocyte ratio in patients with early-stage mycosis fungoides

Neutrophil-lymphocyte ratio (NLR), an indicator of inflammation, has been lately demonstrated as a prognostic factor and an indicator of disease activity in various diseases. However, the effects of NLR have not been investigated in mycosis fungoides (MF) patients yet. The aim of this study is to investigate the relationship between the NLR and treatment demand (systemic PUVA and/or chemotherapy), time to treatment, progression in stage, and time to progression in stage in MF patients. The data of 117 patients, who were followed with the diagnosis of MF at the Department of Dermatology in Istanbul Training and Research Hospital between April 2006 and January 2016, were analyzed retrospectively. The cutoff score for NLR was determined as 2 according to the median NLR level which was 1.96. At the time of diagnosis, the median age of patients was 54years (range, 21-90) with 62 (53%) female and 55 (47%) male. Seventy-seven (65.8%) patients required treatment during follow-up. Sixty-three (53.8%) patients showed progression in disease stage. There was no significant difference in treatment demand, time to treatment, progression in stage, and time to progression in stage in patients with a NLR ≥ 2 and NLR < 2 (p = 0.331, 0.987, 0.065, and 0.119, respectively). It seems that there is no association between the NLR and treatment demand, time to treatment, progression in stage, and time to progression in stage in MF patients.

Relation of admission neutrophil/lymphocyte ratio to angiographic no-reflow phenomenon in patients with ST-elevated myocardial infarction undergoing primary coronary intervention

To investigate the relationship of the neutrophil/lymphocyte ratio (NLR) on admission and angiographic no-reflow phenomenon in patients with ST-segment elevation myocardial infarction (STEMI) who had undergone primary percutaneous coronary intervention (PCI). 232 patients who had undergone PCI between 2010 and 2013, were included and divided into two groups based upon the thrombolysis in myocardial infarction (TIMI) flow gradings. No-reflow was defined as post-PCI TIMI Grade 0, 1 and 2 flows (group I). Normal-flow was defined as TIMI 3 flow (group II). Receiver operating characteristic curve (ROC) analysis was used to identify the predictive effect of NLR on no-reflow phenomenon. Relationship of NLR and no-reflow was assessed by multivariate logistic regression. All statistical calculations and analyses were performed using SPSS 11.0. NLR was significantly higher in group I (n = 45) compared with group II (n = 187) [4.1(2.4-6.5) vs. 2.4 (1.7-3.8), P = 0.001]. In ROC analysis, NLR>3.2 predicted no reflow with 80% sensitivity and 73% specificity. Patients with elevated NLR had a higher incidence of no-reflow phenomenon than those with non-elevated NLR (34.8% vs. 9.3%, P < 0.001). Also, NLR (>3.2) was an independent predictor of no-reflow development [odds ratio 3.70, 95% confidence interval(1.39-9.80), P = 0.009]. NLR was an independent predicator for no-reflow development in STEMI patients who had undergone PCI. This simple and low-cost parameter could provide useful information for the early risk evaluation on these patients.